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交锁髓内SIGN钉治疗胫骨干骨折的疗效

Outcome of intramedullary interlocking SIGN nail in tibial diaphyseal fracture.

作者信息

Khan Irfanullah, Javed Shahzad, Khan Gauhar Nawaz, Aziz Amer

机构信息

Department of Orthopaedics and Spine Surgery, Ghurki Trust Teaching Hospital / Lahore Medical and Dental College, Lahore.

出版信息

J Coll Physicians Surg Pak. 2013 Mar;23(3):203-7.

Abstract

OBJECTIVE

To determine the outcome of intramedullary interlocking surgical implant generation network (SIGN) nail in diaphyseal tibial fractures in terms of union and failure of implant (breakage of nail or interlocking screws).

STUDY DESIGN

Case series.

PLACE AND DURATION OF STUDY

Orthopaedics and Spinal Surgery, Ghurki Trust Teaching Hospital, Lahore Medical and Dental College, Lahore, from September 2008 to August 2009.

METHODOLOGY

Fifty patients aged 14 - 60 years, of either gender were included, who had closed and Gustilo type I and II open fractures reported in 2 weeks, whose closed reduction was not possible or was unsatisfactory and fracture was located 7 cm below knee joint to 7 cm above ankle joint. Fractures previously treated with external fixator, infected fractures and unfit patients were excluded. All fractures were fixed with intramedullary interlocking SIGN nail and were followed clinically and radiographically for union and for any implant failure.

RESULTS

Forty one (88%) patients had united fracture within 6 months, 5 (10%) patients had delayed union while 4 (8%) patients had non-union. Mean duration for achieving union was 163 + 30.6 days. Interlocking screws were broken in 2 patients while no nail was broken in any patient.

CONCLUSION

Intramedullary interlocking nailing is an effective measure in treating closed and grade I and II open tibial fractures. It provides a high rate of union less complications and early return to function.

摘要

目的

根据骨折愈合情况及植入物失败情况(髓内钉或交锁螺钉断裂)来确定髓内交锁手术植入物生成网络(SIGN)钉治疗胫骨干骨折的疗效。

研究设计

病例系列研究。

研究地点和时间

2008年9月至2009年8月,拉合尔医学与牙科学院古尔基信托教学医院骨科与脊柱外科。

方法

纳入50例年龄在14 - 60岁之间的患者,性别不限,这些患者在2周内报告有闭合性骨折以及Gustilo I型和II型开放性骨折,无法进行闭合复位或复位效果不满意,骨折部位位于膝关节以下7厘米至踝关节以上7厘米。排除先前接受过外固定架治疗的骨折、感染性骨折及不适合的患者。所有骨折均采用髓内交锁SIGN钉固定,并进行临床和影像学随访,观察骨折愈合情况及植入物是否失败。

结果

41例(88%)患者在6个月内骨折愈合,5例(10%)患者延迟愈合,4例(8%)患者未愈合。骨折愈合的平均时间为163 + 30.6天。2例患者的交锁螺钉断裂,无患者的髓内钉断裂。

结论

髓内交锁钉内固定是治疗闭合性及I级和II级开放性胫骨骨折的有效措施。它能提供较高的骨折愈合率,并发症少,且能使患者早期恢复功能。

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